Introduction: The dental needs of Indian Army personnel have been periodically assessed to aid planners in identifying the requirements for dental care resources and the best allocation of those resources to provide optimum treatment, whereas in Karnataka police service the personnel dental needs are neither assessed nor provided with treatment. Objectives: The aim was to assess and compare the oral health status and treatment need among personnel of Armed Forces of India in comparison with police services. Materials and Methods: Oral health status was assessed among 300 personnel each from Indian Army and Karnataka police service using WHO proforma (1997). Study was conducted at ASC, Pioneer and Madras Engineering Group and Centre Bangalore for Army personnel and in 3 rd and 4 th battalion Bangalore for Karnataka state Police services. Results: About 45.3% of police personnel suffered from dental caries when compared to 42.3% of army personnel. The decay, missing and filled teeth of the army personnel was found to be 1.30 ± 2.33, and that of police personnel was 1.71 ± 2.67. About 37 (12.3%) army personnel had bleeding gums, 122 (40.7%) had calculus and 4 (1.3%) with pocket 4-5 mm compared with 38 (12.7%) police personnel with bleeding gums, 116 (38.7%) had calculus, 16 (5.3%) with pocket 4-5 mm and 5 (1.7%) with pocket 6 mm or more. Conclusion: The prevalence of the oral diseases namely dental caries and periodontal diseases was relatively high in police personnel when compared to the army personnel.

How to cite this article:
Chandar R S, Patankar SP. Comparison of oral diseases status and treatment needs between armed forces personnel and Karnataka police service in Bengaluru city.J Indian Assoc Public Health Dent 2014;12:268-271

The oral health of a soldier or police personnel directly affects the routine day to day work schedule and result in the risk of dental emergency while deployed. Maintaining a high level of good oral health throughout the force is an integral part of overall combat readiness as clinical dental resources are not always readily available in the deployed environment. [1],[2],[3],[4],[5],[6],[7]

Historically, 20-25% of all soldiers will experience a dental emergency during a 1-year deployment. [7] The largest number of soldier complaints is about lack of adequate dental support. [8] The average time a unit loses a Soldier with a dental emergency which requires evacuation to the rear is 5 days. Liewehr calculates that this fact leads to a potential loss to a division of 18,000 man-days during a 1-year deployment. [7]

Oral health is an essential part of achieving and maintaining readiness to deploy and fight. The dental health of the military personnel has a significant impact on military operations since the untreated oral conditions can result in increased prevalence of dental disease and nonbattle injury for deployed soldiers. [9],[10],[11]

Dental caries prevalence in the central region of Karnataka, including Bangalore is 34.2% according to National Oral Health Survey 2002-2003. Similarly, the periodontal problem such as bleeding gums, calculus or pockets in the age group of 35-44 years is found to be 94.5%. [12] Hence assimilating epidemiological evidence for the prevalence of periodontal disease in this population is of importance.

An extensive search of review of the literature has clearly shown that no study has been done to compare the oral health status and treatment need among personnel of Armed Forces of India in comparison with police services. Hence, this study was undertaken to compare the oral disease Status and treatment needs between personnel in Armed Forces and Karnataka Police Service in Bangalore City, and hence that a preventive protocol can be formulated in order to reduce the extent and severity of dental diseases.

Materials and Methods

The study was conducted on the Armed force Personnel at three Battalion namely ASC, Engineers and Pioneers, medical inspection rooms in Bangalore who reported for the routine annual dental inspection. The study on the Karnataka Police was conducted at the 3 rd and 4 th Battalion, Madiwala, Bangalore. This included all the policemen posted at the battalion Head Quarters and the policemen who are attending the training program held at the Battalion.

The permission to conduct a survey for the Armed forces personnel was obtained from the Station Commandant Bangalore and the Commanding Officer of Military dental center Bangalore. For the Karnataka police the permission was obtained from the Commandant of 3 rd and 4 th Battalion, Madiwala, Bangalore. Ethical clearance was got from the ethical committee of GDC and RI Bangalore. Prior to the commencement of the main study, a pilot study was conducted to calibrate the examiner. Thus, a comparative study with 300 serving Armed Force personnel and 300 serving Karnataka police personnel between the age 21-year and 60-year was conducted during the months of October and November 2010. Convenient sampling method was followed for this study. Known case of HIV/HB + ve personnel and the subjects on immunosuppressive drugs were excluded from our study.

Before the clinical examination was conducted they were interviewed using a structured profoma and a questionnaire was distributed among the subjects that was essential to match both cohorts in term of ranks and years of service. Clinical examination of the both armed force and police personnel was conducted through the WHO Basic Oral Health Assessment form (1997). [13] Each person was examined on an upright office chair using natural light. The subjects were examined for assessment of dispersion and severity of dental caries and periodontal diseases.

The examination for dental caries was done with the help of a sterile mouth mirror and Community Periodontal Index (CPI) probe. The dentition treatment needs were determined using the guidelines of the WHO survey methods. [13] No radiographic evaluation could be undertaken for the diagnosis as it was a field study. Periodontal status was measured by means of the CPI Index using the light weight WHO periodontal probe Periodontal parameters included bleeding on probing, presence of calculus, pocket depth and clinical attachment loss. Recording was done with the help of a trained assistant

The data obtained was analyzed using the SPSS version 14.0 (IBM). Descriptive statistics was computed. The P value was taken as significant when < 0.05 (confidence interval of 95% was taken).

Results

Mean age was 30.4 ± 9.2 years among army personnel and 33.8 ± 8.9 years among police personnel; maximum subjects belonged to 26-30 years age group in both the forces [Figure 1].{Figure 1}

Healthy periodontium was seen in 137 (45.7%) army personnel when compared to 125 (41.7%) police personnel however the degree of periodontal disease was severe in police personnel with 16 (5.3%) pocket 4-5 mm and 5 (1.7%) pocket 6 mm or more. Bleeding gums and calculus present were almost similar when compared to [Table 1]. Loss of attachment of 4-5 mm in army personnel was 5 (1.7%) when compared to 13 (4.3%) in police personnel.

Among army personnel, 127 (42.4%) experienced caries when compared to 136 (45.3%) police personnel. Difference in Mean decayed teeth was statistically significant (P < 0.05) between the army personnel and the police personnel. The mean decay, missing and filled teeth for army personnel was 1.30 ± 2.33 and for police personnel it was 1.71 ± 2.67, which was statistically significant (P < 0.05) [Table 2].{Table 1}{Table 2}

The impact of the acute stomatological conditions on the reducing of the combat readiness is an important concern for the military/police planners. Classification of dental health is the primary condition for research and assessment of the army/police dental readiness for combat. [11]

Mean age of study subject both from army and police were 30.4-year and 33.8-year respectively, which is more (36-year) in the study by Sutthavong et al. [11] and less (27.39-year) in study by Sandoval et al. (2008) [14] and in line (32-year) with study by Dilip (2005) [15] in Karnataka police.

Amongst army personnel in the present study, 45.7% had healthy periodontium, 12.3% had bleeding gums which is in line with study done by Sandoval et al. (2008) [4] with 10% having bleeding; 40.7% had calculus which is less when compared to the study by Sandoval et al. (2008) [11] (72.6%). Whereas in police personnel, 41.7% had healthy periodontium which is much more than the study by Dilip (2005) [15] (9%); About 12.7% had bleeding gums, which is less than the study by Dilip (2005) [15] (37%); 38.7% had calculus, which is less than the study by Dilip (2005) [15] (53%); About 5.3% with pocket 4-5 mm and 1.7% with pocket 6 mm or more which is more when compared to 1% in the study by Dilip (2005). [15]

Caries experience was seen in 42.4% army personnel which are more than study by Sutthavong et al. [3] (22%), whereas when compared to police personnel 45.3% experienced caries which is less as compared to 74% in study by Dilip (2005). [15] More number of caries lesions was observed among police personnel as compared army personnel which may be due to absence of routine dental inspection program in the police services when compared with the regular annual dental inspection program actively present in the Armed Forces. The increased number of caries lesions among police personnel is reflected directly in its treatment needs which is about 62.4% when compared to army personnel of about 50.1%.

Summary and Conclusion

The present study showed that the prevalence of the major oral diseases namely dental caries and periodontal disease is higher in policemen compare to the Army men.

Improved access to dental care, as well as dental health education along with periodic dental check-up, is mandatory to ensure optimum dental health especially for the Karnataka police service. Till such time, the authorities establish comprehensive dental care facilities for the policemen, the Dental Colleges in the city can adopt the Police Training Schools and provide the services.

Armed forces needs to strengthen their existing Oral health care delivery system by emphasizing more on to their preventive aspect to further bring down the oral disease load by assessing their dietary consumption, life style, stress level and other associated risk factors.